The AAO Journal, 2008/12, 18(4):12-17, type of study: ,ret,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

medical education [684]
real patient encounter [1]
retrospective study [339]

Abstract:

Background Because primary care physicians see a large number of patients with musculoskeletal problems, osteopathic clinical skills are important for successful patient care. We have incorporated a peer assessment of osteopathic medical students dubbed a “real patient encounter” or “RPE” as an educational exercise. A real patient encounter (where students carry out selected aspects of medical history taking, physical examination, differential diagnosis, treatment, and evidence-based medicine) performed by second year osteopathic medical students using first year medical students as patients was studied to determine if the encounter has benefit in developing osteopathic clinical skills. Methods First and second year osteopathic medical students at A.T. Still University - Kirksville College of Osteopathic Medicine participated in a pseudo patient-physician exercise, dubbed real patient encounter, for the Osteopathic Theory and Methods course in the spring quarter of 2006. Osteopathic medical students were evaluated and treated with osteopathic manipulation to evaluate levels of skill and provide a peer assessment and feedback. The first year students presented as patients with mostly self-selected musculoskeletal and/or related organ system medical problems for evaluation and osteopathic treatment by the second year students. Second year student doctors documented areas of somatic dysfunction and pain levels experienced by the first year student patients before administering osteopathic treatment. For extra credit, the first year students completed a post-encounter electronic questionnaire evaluating second year student performance. Percentages were calculated to assess the data. Results Second year medical students identified 3.9±1.1 (mean±SD) different regions of somatic dysfunction with a range of 1 to 7 body regions out of 9 reported with somatic dysfunction in individual first year students. Using a standard, 11-point analog pain scale, first year students reported a level of pain of 2.7±1.8, with levels ranging from 0 to 8. Using a standard Likert scale to rate the care given by the second year students, first year students reported satisfaction ranging from 71% to 97% in various categories. Conclusions Results seem to indicate that peer encounters called RPEs are valid academic exercises that are well received by student patients and doctors, thereby validating the osteopathic clinical skills taught at colleges of osteopathic medicine.